Provider Demographics
NPI:1932555349
Name:TRINITY HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:TRINITY HOME HEALTHCARE LLC
Other - Org Name:TRINITY HOME HEALTHCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-601-2644
Mailing Address - Street 1:62 PARKER ST. SUITE 11
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440
Mailing Address - Country:US
Mailing Address - Phone:978-601-2644
Mailing Address - Fax:
Practice Address - Street 1:62 PARKER STREET. SUITE 11
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440
Practice Address - Country:US
Practice Address - Phone:978-601-2644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9398330251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health